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Military Medicine at Little Bighorn

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Military Medicine at Little Bighorn Military Medicine at Little Bighorn LG Walker Jr, MD, FACS The 597 men of the 7th Cavalry Regiment of the US dition of the 7th Cavalry into the Black Hills of Army, with 35 Indian scouts, and 15 quartermaster em- present-day South Dakota “to obtain the most infor- ployees and civilians, under the command of Lieutenant mation in regard to the character of the country and Colonel George Armstrong Custer met with disaster on the possible routes of communication through it.” June 25 and 26, 1876, on the bluffs overlooking, and in This was sacred country to the Sioux and, then, part the valley along, the Little Bighorn River in southeastern of their reservation. When gold was discovered there, Montana.1 The story of the battle is well known, but less prospectors entered the Black Hills in droves, irre- known are its medical aspects.The article reviews the 7th spective of the risks, which led to more violence and Cavalry’s medical resources, medical personnel, equip- death. An early attempt by the government to buy the ment, types of wounds encountered, and mortality rate. Black Hills from the Sioux was thwarted by Sitting Of interest is how medical care had changed from that of Bull and Crazy Horse. In December 1875, President the Civil War, a decade earlier. Briefly discussed are why Grant ordered all Indians back to their reservations by and how the battle occurred. January 31, 1876. When they failed to do this, they were deemed hostile and plans were made to attack HISTORIC SITUATION them. Immigrants as they streamed across the West, crossed the Custer’s regiment was part of a larger force de- traditional buffalo hunting grounds of the Plains Indi- signed to drive the Sioux and Cheyenne back to the ans, sometimes causing loss of life and provoking reservations and away from their favored buffalo pitched battles. The Bozeman Trail, along the upper hunting grounds. There was a pincer movement to branch of the Platte River, was one such point of con- close in on the Indians, with General George Crook flict. Army posts established along the Trail to offer pro- to come up from Wyoming from the south, Colonel tection were frequently undermanned, leaving settlers at John Gibbon from Montana on the west, and General 2 risk for attack and death. One attempt to deal with the Alfred Terry from the east. Custer, under the Terry volatile situation was the Fort Laramie Treaty of 1868, command, left Fort Abraham Lincoln near Bismarck where US Commissioners and a variety of Sioux chiefs on May 17 going west. Crook coming from the south and subchiefs signed a treaty to allow for peaceful use of was turned back by a hostile force led by Crazy Horse the Bozeman Trailin return for Indian reservations. This at Rosebud Creek in mid-June, leaving only Gibbon’s encompassed almost all of present-day South Dakota and Terry’s forces to close in on the Indians. west of the Missouri River, including the Black Hills, Whether by rashness, lack of military intelligence, or and other considerations. The Sioux were to allow the stupidity, Custer entered the fight alone on June 25. railroads to build unimpeded across the country and After crossing the mountains between the Rosebud and agree to cease attacks on travelers and settlers. In com- the Little Bighorn Rivers, he encountered an Indian vil- pliance, the majority of the Sioux settled on the reserva- lage in the Bighorn Valley that was about 3 miles long by tions to become dependent on government food and 1 mile wide and contained an estimated 2,000 to 3,000 services, but Chiefs Sitting Bull, Crazy Horse, and Gall warriors, and many more women and children. Custer, refused to sign at Fort Laramie and remained on their known for his daring assaults in both the Civil War and traditional hunting grounds. in previous Indian battles, did not wait for Colonel Gib- In June 1874, Custer was ordered to lead an expe- bon’s army to arrive from the northwest. Fearful of los- ing the element of surprise, he pushed ahead with the attack. Taking 5 of the 12 companies with him to their Received April 2, 2005; Revised June 29, 2005; Accepted June 30, 2005. deaths, he rode along the bluffs overlooking the Little Charlotte, NC. Correspondence address: LG Walker Jr, MD, FACS, 1053 Bolling Road, Bighorn River, with the probable intention of attacking Charlotte, NC 28207-2205. the village downstream. He sent Major Marcus Reno © 2006 by the American College of Surgeons ISSN 1072-7515/06/$32.00 Published by Elsevier Inc. 191 doi:10.1016/j.jamcollsurg.2005.06.273 192 Walker Military Medicine at Little Bighorn J Am Coll Surg with three companies across the shallow river, which was across the river and up a steep bluff. Indians on all sides 30 yards wide in places, to attack the village from the poured rifle bullets into the troopers and, in some cases, south. He ordered Captain Frederick Benteen, with pulled them off their horses and clubbed them to death. three companies, to scout for escaping Indians toward Porter told of treating one soldier with a chest wound the Bighorn Mountains to the west. Custer apparently who pleaded with him to save him, but evacuation of the believed that the Indians would not fight, but would wounded was out of the question. Porter later recalled, make every effort to escape from his lightning assault. “My horse was rearing and plunging, and I had all I He assigned one company to escort and guard the pack could do to hold him. The Indians in their mad pursuit train in the rear. of our troops did not notice me in the timber. They were Custer’s troops entered the battle better armed than passing within 10 feet of where I was. I placed laudanum their opponents. Troopers carried a 7.5-pound Model on the wound and bandaged it as best I could and again 1873 Springfield “Trapdoor” carbine with an effective mounted my frightened horse.”8 Several men without range of 500 to 600 yards, along with a Model 1873 mounts hid overnight in the woods, enabling them to Single Action Colt .45 revolver known as the “Peace- reach safety on the bluff under cover of darkness. Dr maker” or the “thumb buster,” sighted for 25 yards.3 DeWolf was killed while scaling the bluff on his horse Indians carried a variety of weapons, most with shorter during the rout. This left Dr Porter, whose horse carried range and less accuracy, including clubs and arrows for him safely up the bluff, as the only surviving surgeon of close combat. the regiment. Reno considered it to be a charge to a defensible position, others a retreat. This issue led Reno MEDICAL PERSONNEL to request a court of inquiry in 1879 to clear himself of The 7th Cavalry went into battle with three surgeons, charges of cowardice. one regular Army, and two on contract.4-6 Dr George At bluff top, a defensive perimeter was hastily devel- Lord, the regular Army surgeon, was 30 years old, born oped by the survivors of Reno’s and Benteen’s troops in Boston and grew up in Maine, and graduated from and those with the pack train. Within the perimeter in a Chicago Medical School. He was known to be ill on the saucer-shaped depression near the center, Dr Porter es- day of the battle and it was questionable if he could go tablished an open field hospital on top of canvas tarpau- with Custer’s five companies but, when asked, he re- lin. A red cross marks the site today. At first some of the fused to allow another surgeon (Dr Porter) to take his wounded tumbled off their horses into the designated place, and so he rode to his death. medical area. Later men were brought in as they were The two contract surgeons were Dr James DeWolf, a wounded. Water soon ran out. Although they were native of Pennsylvania, 33 years old, and a graduate of within sight of the river, no water could be gotten with- Harvard School of Medicine, and Dr Henry Rinaldo out great personal risk.The wounded were in agony with Porter, from upstate New York [Lee Center], 28 years thirst in the fierce Montana heat before volunteers could old, and a graduate of Georgetown University School of retrieve water. Fifteen of these water carriers were later Medicine. Both contract surgeons rode with Reno’s bat- awarded the Medal of Honor for their bravery. talion across the river. Each had an orderly to carry sup- plies but no trained assistant. Neither surgeon rated a uniform because they were on contract status. We know MEDICAL SUPPLIES that Dr Porter wore a linen duster over his clothes into How did military medicine and surgery differ from that battle. This garment had become fashionable for travel- practiced in the Civil War a decade earlier? The major ers on the railroads to protect their clothes from the dirt advance was based on the work of the British surgeon, and cinders in the days of open car windows. Porter’s Joseph Lister (1827–1912).9 Learning of Pasteur’s work duster appeared to attract the attention of Indian marks- on fermentation in 1865, Lister applied this to the prob- men and he was warned by chief guide “Lonesome lem of wound infections and successfully used carbolic Charley” Reynolds moments before the latter took a acid to dress the wound of an 11-year-old boy in Glas- fatal bullet.7 gow who had sustained an open fracture of his left leg When Reno’s men met overwhelming force in the when crushed by a cart wheel.
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